Provider Demographics
NPI:1659961738
Name:ESTRELLA, KRISTINE-GEM D (PA-C)
Entity Type:Individual
Prefix:
First Name:KRISTINE-GEM
Middle Name:D
Last Name:ESTRELLA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5731 S FORT APACHE RD STE 130
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5666
Mailing Address - Country:US
Mailing Address - Phone:702-272-1600
Mailing Address - Fax:
Practice Address - Street 1:5731 S FORT APACHE RD STE 130
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5666
Practice Address - Country:US
Practice Address - Phone:702-272-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical